US and UK investigate unusual cases of hepatitis in young children

sPublic health officials in the United States and the United Kingdom are investigating several unusual cases of acute hepatitis in young children, the cause or causes of which are not currently known.

Evidence from the United Kingdom and Alabama – where nine cases have been reported since last fall – suggests that the adenovirus may be involved. Adenoviruses usually attack the respiratory tract, causing cold-like illnesses. But it has been linked to cystitis, infection and occasional hepatitis, although it rarely affects children who are not immunocompromised.

In a statement released Thursday, the Centers for Disease Control and Prevention said it is working with Alabama to investigate the cases and is working with other state health departments to see if there are other cases elsewhere. In an alert to doctors issued by the Alabama Department of Public Health in early February, it said it was aware of a case in another state but did not provide details.

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“The CDC is aware and working with the Alabama Department of Public Health to investigate nine cases of hepatitis in children — ages 1 to 6 — who have tested positive for adenovirus since October 2021,” said Kristin Nordlund, a spokeswoman for the agency. . in an advertisement.

The Centers for Disease Control and Prevention is working with state health departments to find out if there are other cases in the United States and what is causing those cases. For now, adenovirus may be the culprit, but researchers are still learning more — including ruling out the most common causes of hepatitis.

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Cases have been found in various parts of the state, and investigations so far have not found any link between the children, said Karen Landers, a physician with the Alabama Department of Public Health. British investigators also found no links between the two cases.

“It’s not uncommon to see children with acute hepatitis,” Landers, a pediatrician of 45 years, told STAT in an interview. “Look seriously with the children [hepatitis] In the absence of serious underlying health problems they are very rare. That’s what really sets us apart in Alabama.”

There is a group of adenoviruses that can infect people. Genetic sequencing is done to try to determine if there is one or several types of adenovirus. So far, five of the children have tested positive for type 41, Landers said.

With the spread of the word subjunctive, it is possible to find additional cases. Al-Bais newspaper Did I mention Wednesday The newspaper said that Spain had detected three cases, aged between two and seven years. One of the children needed a liver transplant.

As in the UK, children in Alabama are very sick, said Helena Gutierrez, medical director of the Pediatric Liver Transplant Program at the University of Alabama at Birmingham. “We’ve seen a whole range of cases from acute hepatitis to acute liver failure,” she told STAT in an email.

Nirav Shah, director of the Maine Center for Disease Control and president of the Association of State and Territory Health Officials, said the organization was aware of cases in the UK but had not been informed of similar cases in this country. “We have reached out to the US Centers for Disease Control and Prevention to find out more and also to discuss how countries can monitor these cases,” he said.

In the United Kingdom, where nearly 75 cases have been reported in England and Scotland, few children have had or may need liver transplants.

Several children in the UK have been tested for adenovirus and SARS-CoV-2, the virus that causes Covid-19. But the former appears to be the prime suspect, according to A. scientific material About the Scottish numbers published Thursday in the online magazine Eurosurveillance.

However, even if the cause was adenovirus infection, there could be an epidemiological link, the authors suggested, noting that young children–many cases under five years of age–who were not exposed to the normal range of germs during the epidemic may have become infected. When masks were removed and social distancing measures were lifted.

The authors, from Public Health Scotland, wrote, “At the time of publication, the main hypotheses centered on adenovirus – a new species with a distinct clinical syndrome or a circulating variant that routinely severely affects young immunocompromised children,” the Royal Hospital for Children in Glasgow, Glasgow Center Glasgow University of Glasgow Virus Research.

“The latter scenario may be the result of limited social mixing during the Covid-19 pandemic,” they said. Five of the thirteen children described in the article tested positive for adenovirus.

Hepatitis – inflammation of the liver – is a condition that can result from a number of factors, although a viral infection is often the cause. Several hepatitis viruses – A, B, C, D, and E – are common causes of hepatitis but have been excluded in these cases.

The European Center for Disease Prevention and Control issued attention On Tuesday, doctors urged to look for and report cases of acute hepatitis in children 16 and younger, with tests that rule out hepatitis A, B, C, D or E.